Cardiac Functions in Alcoholic and Non-Alcoholic Cirrhosis

Cirrhosis is a chronic liver disease with systemic complications. Cardiac involvement in cirrhosis is less studied and rarely reported. Here an attempt was made to design a prospective analytical observational study to find out the functional status of the heart in established alcoholic (n=32) and non - alcoholic (n=68) cirrhosis patients compared with asymptomatic healthy controls. Rigid criteria was adopted in the selection of cases in order to exclude co morbid conditions and other contributing factors. This study was confined among males as women alcoholics could not be identified in this area. The data was analysed statistically. Left ventricular systolic function parameters (LVIDs, LVIDd, IVSd, LVPWd and ejection fraction) were comparable between alcoholics, non alcoholics and controls (p>0.05). Pulmonary artery systolic pressure (PASP) in cirrhosis patients and controls ranged from 12.5 to 56 mm Hg and 13 to 29 mm Hg respectively. The mean among the two groups were 28.2+9.06 and 20.4+4.21 mm Hg respectively. The difference among cirrhotics and controls with reference to PASP were statistically highly significant (p=0.0001). 54 The LV mass in cirrhotics patients and controls ranged from 74 to 271 gms and 90 to 120 gms respectively. The mean among the two groups were 162.26+50.65 and 159.33+41.77 grams respectively. But the difference was not statistically significant (p=0.8917). 48 cirrhotic patients (48%) had diastolic dysfunction compared to 10 persons (25%) in the control group which was significant (p<0.05). This significance persisted in both alcoholic and non alcoholic groups. Majority of patients in both subsets of cirrhotic with diastolic dysfunction showed LV relaxation abnormality pattern. (68% in alcoholic and 52% in non alcoholic group respectively) There was no significant difference in cardiac functions parameters when alcoholic cirrhotics were compared with non alcoholic cirrhotics (p>0.05). The present study has brought out the pattern of cardiac involvement and the comparability of observations with published series. More molecular and clinical studies are required to design effective therapeutic measures to prevent the progression of cirrhosis and its systemic complications